Individual
JODIE BEAUCHAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1389 W MAIN ST, WATERBURY, CT 06708-3104
(203) 757-1474
(203) 757-1474
Mailing address
1389 W MAIN ST, WATERBURY, CT 06708-3104
(203) 757-1474
(203) 757-1474
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
3450
CT
Other
Enumeration date
07/30/2007
Last updated
07/30/2007
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